What happens after a policy is sold: claims, nominations, grievances, records and KYC. This topic has 17 entries.
Claims and policyholder serviceClaim settlement ratioClaim settlement ratio is the share of claims an insurer pays out of all the claims it had to decide in a year, reported for life insurers by number of death claims and by amount.Claims and policyholder serviceClaim intimationClaim intimation is the first notice to an insurer that an insured event has happened, given by the policyholder, nominee or a channel, which starts the claim process and the settlement clock.Claims and policyholder serviceDeath claimA death claim is the request to a life insurer to pay the death benefit after the life assured dies, made by the nominee, assignee or legal heirs and settled under IRDAI's claim timelines.Claims and policyholder serviceMaturity claimA maturity claim is the payout a life insurer makes when a policy completes its term with the life assured alive, due on the maturity date under IRDAI's 2024 servicing rules.Claims and policyholder serviceClaim repudiationClaim repudiation is an insurer's refusal to pay a claim, in full or in part, on grounds such as an exclusion, a breach of policy terms, non-disclosure or fraud, which it must explain in writing.Claims and policyholder serviceSection 45 of the Insurance Act, 1938Section 45 of the Insurance Act, 1938 bars a life insurer from questioning a policy on any ground once three years have passed from issue, risk start, revival or rider date, whichever is later.Claims and policyholder serviceFree look periodThe free look period is the 30 days a buyer of a life or new individual health policy gets, from receiving the policy document, to review it and cancel for a refund without giving a reason.Claims and policyholder serviceNominationNomination is the policyholder's choice of one or more people to receive the policy money on their death, made under Section 39 of the Insurance Act, 1938 and now required on every life proposal.Claims and policyholder serviceNominee vs legal heirNominee vs legal heir is the gap between the person an insurer pays on a policyholder's death and the people who own the money under succession law, decided in life insurance by Section 39(7).Claims and policyholder serviceAssignment of a policyAssignment of a policy is the transfer of the policyholder's rights under an insurance policy to another person or lender, made under Section 38 of the Insurance Act, 1938 by endorsement or deed.Claims and policyholder serviceMarried Women's Property Act policyAn MWP Act policy is a life policy a married man takes on his own life for his wife and children under Section 6 of the Married Women's Property Act, 1874, held in trust away from his creditors.Claims and policyholder serviceSurveyor and loss assessorA surveyor and loss assessor is an IRDAI-registered professional who inspects a general insurance loss, checks its cause against the policy and assesses the amount payable under Section 64UM.Claims and policyholder serviceSalvageSalvage is the value left in damaged insured property after a loss, such as a wrecked car or fire-damaged stock, which is deducted from the claim or taken over by the insurer after payment.Claims and policyholder serviceBima BharosaBima Bharosa is IRDAI's online grievance management system, the renamed IGMS, where policyholders register and track complaints against insurers and IRDAI monitors how they are resolved.Claims and policyholder serviceGrievance redressal in insuranceGrievance redressal in insurance is India's tiered route for policyholder complaints: the insurer's grievance officer, IRDAI's Bima Bharosa, the Insurance Ombudsman, then consumer courts.Claims and policyholder serviceInsurance repository and e-insurance accountAn insurance repository is an IRDAI-registered entity that holds policies in electronic form in a free e-insurance account (eIA), so one account can store and service policies from many insurers.Claims and policyholder serviceCKYC and KYC in insuranceKYC in insurance is the identity and address check insurers must run on every customer under anti-money laundering law. CKYC is the central registry that lets one verified record be reused.